So, what IS in my backpack? Reflecting on how I pack strategically for the day, I realized that the items also tell the story of my day; what is supposed to happen (usual items), what might happen (preparedness items), and what actually happened (used items).
Each morning I pack my shoulder bag considering the above at length and mentally preparing myself for a wide range of flexibility. Just as interesting, perhaps, is what I DON'T keep in my bag - anything that would normalize body temperature such as acetaminophen (Tylenol) or ibuprofen. Though cases of Ebola virus disease remain on the downswing in my area, I want to be the first to know I'm running a temperature. We take our temperature twice daily at the lodge and are screened at the entrance to any clinic or hospital. If there's a blip, I'll be sure to know immediately.
So, back to what is in the bag. Well, the usual personal items, of course and then, the following:
First Aid kit - effectively, Lisa's clinic in a bag complete with injectable medications, ear/eye/ nose/throat care, suturing capability and wound-care supplies. This bag has come in handy on numerous occasions, as you can imagine, as I find myself very often in some rather remote regions where there is little formal medical care to be found. One day, I was made aware of an older "mammy" who, unfortunately, was thrown from a motorcycle taxi and sustained a large, open wound just below her knee. The hospital was almost two hours away and, perhaps, even more unfortunately, it's unlikely her gaping wound would have been sutured in a timely fashion, if at all. There remains an Ebola fear driven reluctance to treat any open wound in clinics and hospitals—the "collateral damage" I referred to in earlier essays. So, with the older woman and wound before me lying on a locally woven mat in a rather small room crowded with family, I set about the task at hand. Unfortunately, I had no anesthetic to provide and the woman agreed to allow me to continue. I cleansed the wound copiously with clean water and antibacterial soap, then spent the next little while teasing the retracted wound edges together and was able to suture about 80 percent of the laceration leaving the last bit to close on its own. She suffered in silence and allowed me to do the work, as only a Sierra Leonean knows how. I was both awed and honored. Three days later, I returned to the area and saw her gimping to the outhouse then sitting outside on the shady veranda. The following week, she was able to return to her village and continue her rehabilitation. So, yes, my first aid kit is a veritable mobile clinic.
Toilet Paper - no need to expound on this.
Oral Rehydrations Salts (ORS) and Emergen C - While I'm not wearing personal protective equipment (PPE) everyday, I have occasion to suit up and after what feels like losing about a gallon of sweat, replenishing those electrolytes is essential to getting through the rest of the day without feeling like cooked spaghetti.
Camera - not used very often as we work hard to protect patient privacy. Consequently, very few pictures this trip.
Leones - the local currency. A must if you want to buy some safe(r) street food such as bananas or roast peanuts or perhaps some sweet biscuits (cookies) in the small street shops.
And, lastly, my most prized possession - a spoon. Why a spoon? Well, how else does one eat a young "jelly" coconut when the soft, white, fleshy part needs to be liberated from the hard interior shell. And this only after slugging down the cool, potassium rich coconut water; ahhhhh, Africa’s own native ORS. Nothing compares.
Varnes-Epstein is a physician assistant and mid-wife living in rural Gays Mills. She is currently in Sierra Leone working with Partners In Health in the fight against Ebola. Varnes-Epstein was stationed in Sierra Leone in the 1980s as a Peace Corps volunteer.
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Local Medical Practioner sends update from Sierra Leone Ebola Clinics
